Stuck on the Rage Road

Mood specialists are careful to distinguish between occasional hot flashes of anger and the long-simmering irritability and rage—angry outbursts lasting over several days, during both manic episodes and agitated states of depression—that is symptomatic of bipolar disorder. During a manic episode, experts say, mood changes can swing from irritability to euphoria to depression—all within a 25-minute period of time.

“Instantaneous anger that lasts a few minutes and occurs twice a week is not bipolar, it’s being angry,” says David L. Dunner, MD, FACPsych, director of the Center for Anxiety and Depression inMercer Island,Washington. “Irritability can be present during highs and lows, but irritability without elated mood makes me suspect the illness may not be bipolar.”

In other words, everybody gets angry. Just because you have a head-turning temper tantrum doesn’t mean you have bipolar disorder. Anger is a common response to both physiological illnesses like cancer and heart disease and mental illnesses such as intermittent explosive disorder, major depressive disorder and substance-induced mood disorder.

“As bipolar disorder receives more media attention, it’s easy for any type of abhorrent behavior to be attributed to it when in fact, this has to do with one’s temperament,” says Ronald A. Remick, MD, a consultant psychiatrist at St. Paul’s Hospital in Vancouver, British Columbia.

“Bipolar patients are not angry, hostile, irritable people with short fuses,” he emphasizes. “If people with bipolar illness have anger issues, they have anger issues.”

It is, however, a side of bipolar disorder that has long passed under the radar screen. Many people with bipolar say that uncontrolled anger has destroyed their marriages, families and personal relationships, ruined their careers and left them emotionally isolated...